Loading...
HomeMy WebLinkAboutPermit Signage 2009-9-22 225 FIITHSTREET . SPRlNGFIELp, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ~ ee~ City Job Number ..~ lob Location ~ e. '~4 Assessors Map ~ '~ ..~ t Addres. ~ City ~\,','ft\'?!_~T:8:;"31<:ij;\q\~r4'i:,t'f'y{j ~rC6iiiFlii:iorlIns't ~ ';'At:;<-:~;.%L,~Xm-S6'ii":ti\:~'HI;<"'. ~ 6w AfF.-t e. ~ Contractor '~ I 8 Ii ~ e.~ ~ ~. ~ ~ ~ ..~ rt#-)J t ~ ! '~ ~ m CDwtZdO,/ - 13th 'ft{}~ Sf., j 702. 32-3 ( o /l.{O ( Tax Lot 02-8"Ou Owner of Property 70 I~O/, ~ crC-7Ve:' 1f(I(OV l'h('np ?~ra'&8f;3B '77ltO'-( ort. Stat,. Zip Addr,... Phon,. City_ State, Zip Construction Contractors, License # EXpiTP~ , Descripti nn ~/Ti.lN cS,_ , Y~f Date of Removal ' rrf Date of Installation Permit Fee: $225.00 including $100.00 Deposit and applicable fees. By signature, I state and agree that I have carefully completed this application and hereby certify that " ' all information herein is true and correct. 1 further agree and understand that the above described banner(s) and/or portable sigil(s) is not larger than 60 squarefeet,.and will be removed within 30 days from the date listed above. lithe banner(s) and/or portable sign is not removed within the timeline specified, 1 will forfeit the $100.00 deposit. I also understand that this special permit can be issued only twice per calendar year per development area. I also agree to call the inspection line at 726-3769 by the, end of the 30th day to request an inspection to verify the removal of the banner(s) and/or portable sign(s). Thi~ ;""'z:'on~' be' the process to return the $100,00 deposit if the banner(s) and/or portable sign(s) ~ ber, ,e ed]j Signatufp h . ft-<.bu , ~/d2d-/v9 Date of Application lob # Receipt # Issued By ,~ Amount Collected /IS- \ " Shared Drive (T:)IBuilding FonnsIBanncryortablc SignPennit CSD 7-os.doc Status Finaled 225 Fifth Street, Springfield, OR 541- 726-3753 Phone '541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 4360 MAIN ST ASSESSOR'S PARCEL NO.: 1702323102800 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01401 ISSUED: 09/22/2009 APPLIED: 09/22/2009 EXPIRES: 03/22/2010 VALUE: Springfield TYPE OF WORK: Banner PROJECT DESCRIPTION: Banner - ref:C0D2009-00687 Owner: Address: SULLIVAN JOINT TRUST PO BOX 41404;, EUGENE OR 97404 Contractor Type' Sign Contractor OWNER # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: ' Frontyard Setback: Side 1 Setback: . Side 2 Setback: ' Rearyard Setback: Solar Setbacks: ' Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description Type of Construction TYPE OF USE: New Commercial I CONTR.^CTOR INFORMATION I ~U1LD1NG INFORMATION I # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: License Expiration Date Phone n/a Lot Size: Sq Ft Ist Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft GaragelCarport Sq Ft Other: Occupant Load: I DEVELOPMENT INFORMATION I Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: I~UBLIC I:WPROVEMENTS I I Valuation Descriotion I $ Per Sq Ft or multiplier REQUIRED PARKING Total: Handicapped: Compact; Sidewalk Type: DownspoutslDrains: Square Footage or Bid Amount Date Calculated Page I of 2 Value Status Finaled. I 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 inspection, Line ;., CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01401 ISSUED: 09/22/2009 APPLIED: 09/2212009 EXPIRES: 03/2212010 VALUE: !.'i.... '. Total Value of Project Fees Paid I Fee Description ***+ 100/0 Administrative Fee*** <- + 5% Technology Fee Banner Special Permit Amount Paid . , Date Paid Receipt Number $10.00 $5.00 $100.00 9/22/09 9/22/09 9/22/09 2200900000000001076 2200900000000001076 2200900000000001076 Total Amount Paid $115.00 I Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00 a.m. will be made the same working day,,inspections requested after 7:00a.m. will be made the following work day. I RrolJ.ir~~ I~soect.i~,1S I By signature, 1 state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct,"and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at'all " .=, ~""'":() -.-<.U 1,/ h/" l' tractors Signatu/ Date Page 2 of2 . ~: ,225'Fifth Street Springfield, Oregon 97477 541"7.26-3759 Phone '; ,';,~;, '<,; . ., ". ;,' RECEIPT #: r. 2200900000000001076 '., -, \: - . ',":, : "', ~. , . Job/Journal Nurriber.:~,:<:,.;,D'e's'cription, .j;' COM2009cO 140 I "': B'a~ner Speci,alPermit C0M2009-01401 + 5% Technology Fee COM2009-01401 ***+ 10% Administrative Fee*** Payments: Type of Payment Check " cReceintl .-. , :;P;id'~yiij: ' , '''YH1TE HORSE TAVERN '" ::~~C~ .' .~'),h '.;',.":-'. ' 'I, .; Received By djb Check Number Batch ~umber Page 1 of 1 City of Springfield Official Receipt Development Services Department Public Works Department Date: 09/22/2009 Item Total: Authorization Number How Received 1250 In Person Payment Total: 11 :06:33AM Amount Due 100,00 5,00 10,00 $115.00 Amount Paid $1 \5,00 $115.00 9122/2009'